Long-Acting Birth Control Information Act

Summary: The Long-Acting Birth Control Information Act would create a health department program to make long-acting reversible contraceptives (LARCs) more accessible.

Background Summary

According to the Colorado Department of Public Health and Environment, the state’s teen birth rate was cut nearly in half during the first five years of the Colorado Family Planning Initiative, which increases access to long-acting birth control. Both the birth rate and abortion rate for women ages 15-19 fell 48 percent from 2009 through 2014. Previous data for 2009-13 showed a 40 percent drop in teen births and a 35 percent decline in teen abortions.

This extremely successful initiative provided training, operational support, and 36,000 long-acting reversible contraceptives (LARCs)—intrauterine devices (IUDs) and implants—to low-income women in Title X family planning health centers. IUD and implant use among family planning clients grew from 4.5 percent before the initiative to 29.6 percent in 2014. Nationally, only 7.2 percent of women use LARCs.

The initiative also assisted young adult women and contributed to saving millions in taxpayer dollars. From 2009-2014, the birth rate for women ages 20-24 decreased 20 percent and the abortion rate by 18 percent. The state estimates that the Medicaid program avoided spending approximately $79 million in birth-related costs from 2010-2012, meaning the initiative contributed to the savings of at least $5.85 for every dollar spent.

LARCs are 20 times more effective in preventing pregnancy than the pill, contraceptive patch, or vaginal ring. According to a comprehensive study, the pregnancy risk for one year of real-world LARC use is less than one percent, while the pregnancy risk is 9 percent for women who use oral contraception, have the patch or use the vaginal ring; 12 percent for women using the diaphragm; and 18 percent for cervical caps, condoms and sponges.

When health care professionals have adequate training and more information is made available to women, a significantly higher percentage of women choose LARCs. According to a committee of the American College of Obstetricians and Gynecologists,only about 50 percent of ob-gyns offer the contraceptive implant to patients, and although “obstetrician-gynecologists generally have favorable attitudes about IUDs, they may use overly restrictive criteria to identify IUD candidates.” The committee noted that LARCs do not require additional supplies or costs after insertion, making them “highly cost effective,” they have few contraindications, and fertility is restored soon after their removal. “Since implementation of the Affordable Care Act, most insurance plans cover all contraceptives, including LARC methods, with no patient cost sharing…. However, some women do not have coverage under the Affordable Care Act or do not have access to low-cost clinics and may encounter high up-front costs for an IUD or implant. Despite such costs, the implant and the IUDs are highly cost-effective, even with relatively short-term (12-24 months) use.”

Model Legislation

SECTION 1. SHORT TITLE

This Act shall be called the “Long-Acting Birth Control Information Act.”

SECTION 2. FINDINGS AND PURPOSE

(A) FINDINGS—The legislature finds that:

1) Half of all pregnancies in the United States each year are unintended.

2) Long-Acting Reversible Contraceptives (LARCs) are extremely effective at preventing pregnancy, they are extremely safe, and they can provide protection for up to 12 years.

3) According to the Centers for Disease Control and Prevention, only about seven percent of women aged 15-44 currently use LARCs.

4) In Colorado, where there has been a program to make LARCs more widely accessible, the state reported a 48 percent decline in birthrates among teens and a 48 percent decline in teen abortions.

5) High upfront costs, a lack of adequate training for health care professionals, administrative barriers, and insufficient information and education have made LARCs more difficult to access than other forms of birth control.

(B) PURPOSE—This law is enacted to protect the health, safety and welfare of women and families by making Long-Acting Reversible Contraceptives more accessible.

SECTION 3. GREATER ACCESS TO LONG-ACTING REVERSIBLE CONTRACEPTIVES

After section XXX, the following new section XXX shall be inserted:

(A) DEFINITIONS—In this section:

1) “Family planning centers” means health clinics that receive funding under the Title X program overseen by the U.S. Department of Health and Human Services as well as other health clinics that the [Department of Health] finds are qualified and willing to perform comprehensive family planning services.

2) “Long-Acting Reversible Contraceptives” or “LARCs” means highly effective methods of contraception which last for several years and are easy to use. LARCs include, but are not limited to, intrauterine devices and birth control implants.

(B) PROGRAM TO MAKE LARCs MORE ACCESSIBLE

1) There shall be a program administered by the [Department of Health] to improve access to Long-Acting Reversible Contraceptives for women.

b) Training for all public health facilities to ensure that they are qualified and able to insert and remove LARCs;

c) Assistance to family planning centers regarding administrative or technical issues such as coding, billing, pharmacy rules, and clinic management related to the provision of LARC methods;

d) General financial support to expand the capacity of family planning centers to provide LARCs, and to keep them in stock and available for same day access by patients;

e) Education and outreach to the public about the availability, effectiveness and safety of LARCs; and

f) A study of making as many contraceptive methods as possible available both over-the-counter and directly through pharmacies, as California and Oregon have done; and

g) Other services the [Department] deems necessary to improve access to LARCs.

(C) APPROPRIATION

For the [fiscal year] Fiscal Year: $5,000,000 [or appropriate amount] is appropriated to the [Department of Health] to improve access to LARC services.

SECTION 4. REPEAL

The following sections are hereby repealed: [list existing provisions that are inconsistent with this Act].

SECTION 5. SEVERABILITY

The provisions of this Act shall be severable, and if any phrase, clause, sentence or provision is declared to be invalid or is preempted by federal law or regulation, the validity of the remainder of this Act shall not be affected.